A. M. A. Indicted

In Washington, D. C. last year 2,500 low-salaried Government employes chipped in to form Group Health Association, Inc., which hired nine physicians to provide complete medical care for members. Scarcely had the first patient visited the well-equipped G. H. A. clinic when the District Medical Society, a branch of the American Medical Association, turned on the heat. It has been accused of refusing to let G. H. A. doctors use local hospitals, consult with local specialists. Reason: G. H. A. is a health-insurance project, and the A. M. A. is opposed to group health insurance combined with practice, which, it claims, limits a patient's choice of his doctor, and prevents free competition among doctors.

Unless the A. M. A. was looking for a test case, Washington, right under the nose of the Department of Justice, was a bad place for heat on-turning. Last October Assistant Attorney General Thurman Wesley Arnold, in charge of monopoly investigation, haled the District Society before a grand jury because he believed that boycott of the G. H. A. violated the "Sherman Anti-Trust Act. The jury, which included salesmen, executives, engineers, a brewer and a taxicab driver, listened to about 100 witnesses from Washington hospitals and medical organizations all over the country. It learned that the District Society had expelled G. H. A. Physician Mario Victor Scandiffio and had forced another doctor to resign from the G. H. A. staff. It read a resolution of the District Society to throttle "successful operation of G. H. A., Inc." and examined the letters A. M. A.'s Morris Fishbein had sent the society.

Last week the Jury returned an indictment not only against the District Society but against A. M. A., the Washington Academy of Surgery, the Harris County (Texas) Medical Society,* 16 Washington physicians, and five A. M. A. executives, including Official Spokesmen Olin West and Morris Fishbein. /-

The indictment stressed the power of the A. M. A., which claims as members 110,000 of the 145,000 practicing U. S. doctors and, as a corporation, has an income of several million dollars a year. The A. M. A., said the indictment, "condemns as 'unethical' group medical practice on a risk-sharing prepayment basis principally because such practice is in business competition with . . . doctors engaged in [private] practice."

Undaunted by the indictment, A. M. A. Editor Morris Fishbein quoted the House of Delegates: "[We will exhaust], if necessary, the last recourse of distinguished legal talent to establish the ultimate right of organized medicine to ... oppose types of contract practice damaging to the health of the public." A. M. A.'s "legal talent" made it clear that they would take the tack that medicine is a learned profession, not a trade, and thus does not fall within the scope of the Sherman Act. Attorney Arnold hopes that the A. M. A. will soon file a demurrer to the indictment. If the demurrer is granted, Attorney Arnold will be able to take the case directly to the Supreme Court.

*The Harris County Medical Society instituted charges against a physician who had gone to Washington to treat G. H. A. members, later dropped the action. The Society was indicted as proof that the A. M. A. engaged in interstate commerce.

/-In addition to Drs. West and Fishbein: Drs. William Creighton Woodward, head of the Bureau of Legal Medicine, William Dick Cutter, secretary of the Council on Medical Education and Hospitals, Rosco Genung Leland, director of the Bureau of Medical Economics.

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